Tuesday, July 27, 2010

A Dilemma

I'm doing milk math again. At one point, Petunia seemed to be decreasing her milk intake, and I thought that I'd be able to drop a pumping session. That didn't happen. Instead, she ramped her milk intake back up. During the week, Petunia gets four bottles of a day- three at day care and one in the middle of the night, from Hubby. The bottles have between 4 and 6 ounces of milk. She also nurses approximately four times a day- once first thing in the morning, twice in the evening before bed, and once in the middle of the night. I can't really say how much milk she's getting when she nurses, but I'd guess that it is between 3 and 6 ounces each time.

I'm pumping four times a day, three times at work and once before bed. This weekend, I tried to add in an a pumping session each day, but that is hard to do, and I didn't really get that much. I certainly won't be able to make up the difference over the weekends. I've already started taking fenugreek again, and smell faintly of maple syrup- so I know I'm taking enough. Still, I've been slowly depleting my frozen milk supplies. At one point, our freezer seemed to overflow with little plastic bags of milk, frozen in 3 ounce aliquots. Now, I'm down to 6 bags. How did that happen? At the rate I'm using them, I'll be out by next week.

So, I have a decision to make. The way I see it, I have three options:

1. Keep going as we're going, and just replace one bottle each week day with formula. I have no problem with this option in theory, but in practice it would be the first time I've used formula since the first few days of nursing Pumpkin, when we had latch problems and had to supplement. Perhaps because I associate formula use with those difficult times, I'm strangely resistant to this option. I'm usually a fairly rational person, though, so I suspect I can overcome this irrational resistance. But Petunia's never had formula, and may refuse it. Or it may upset her tummy.

2. Stop having Hubby give a bottle in the middle of the night. I'd do all the night time feedings, and would probably therefore need to sleep in on the weekends. Even with that, I'd be really tired, because I wouldn't be able to get my minimum sleep requirement of 4 hours of uninterrupted sleep. Pumpkin's bedtime is too late to make this possible. Now, I could go to bed before she does, but that would probably create more problems than it would solve.

3. Accelerate our plans to introduce dairy and hope that this causes Petunia to get more of her calories from solid foods. According to the latest opinion from the AAP, we could introduce soft cheeses and yogurt now. (When Pumpkin was this age, we were told to hold off on all dairy until she was a year old. So I think these guidelines are really just someone's wild guess.) We may do this anyway, but there is a good chance that it won't work. So I'm not sure I want to bank on it.

I vaguely remember hitting a similar problem at about this time with Pumpkin. I think I was able to add a morning pumping session and some extra weekend sessions and managed to make it through. Adding more pumping sessions is not an option this time- and that realization makes me a bit sad for poor Petunia. (Which is silly, I know, particularly when I look at the wonderful chub on her little thighs and arms. The girl is clearly not starving.)

What do you think? Am I missing any options? What would you do?

18 comments:

  1. Cloud, I really don't think you should do number 2. You need to get that 4 hours. You might need that 4 hours more than Petunia needs 4-6 oz. of breastmilk... only you know that for sure but from reading your other posts on sleep I think that 4 hours is key.

    I would do either 1 or 3, or both. Here's why.

    With number 1... unless Petunia has food sensitivities (if she does then nevermind what I'm saying) she will most likely tolerate formula just fine. I just weaned Annie from nursing to formula and I swear she can't even tell the difference, or if she can, she's not letting on. Millions of babies drink formula. Don't beat yourself up over this. She's a big girl, she's 9 months old, not a teeny weeny little newborn... she'll be ok! And you get to keep your precious 4 hours.

    Regarding number 3... here in Canada its recommended that dairy can be started much earlier. Cheese and yogurt are considered ok early foods (6-9 months). They say no regular cows milk until at least 9 months and to ease it in slowly. By 12 months its considered ok to be on just cows milk and no formula or breastmilk. Of course they recommend breastfeeding longer, but say its not damaging to baby nutritionally if you don't. So maybe try some cheddar cheese at dinner a few nights in a row and see what happens. If nothing... try some yogurt. If nothing... heck, I'd be all over a cows milk bottle once a day, maybe one of the ones during the day where she's also having a meal.

    Whatever you do, you need your sleep. At least try 1 and 3 before considering 2. 1 is probably less "risky" than 3 so maybe start there, unless you just can't get your head around the whole formula thing (which I understand if you can't). Your sleep is just as important here!

    Good luck!!

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  2. Anonymous6:47 AM

    I had the same problem at this age - about 10 months, right? I remember giving DD cow's milk to see what would happen. She handled it fine. For me emotionally, this would be the answer. She's going to drinking cow's milk in a few months anyway, right? I know in my head that there's nothing wrong with formula, but emotional I had a harder time with it than cow's milk. Way to go making it this long with two kids, work and pumping!!! Hang in there. I don't think I'd sacrifice the sleep!

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  3. Anonymous7:37 AM

    My experience was that my kids did not really start eating a lot of solid foods while my milk supply was keeping up with them. At 9-10 months, I simply could not keep up any longer, and they became more hungry for (and more interested in) eating other things. So #3 worked for me.

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  4. I know I'm almost a stranger (commented a few times :)), and I have no idea if you've tried this before, but if it were me, I would think about trying to drop the night feeding, but still pump before bed. I understand why people don't, but it was something I did with my kids when they were capable of making it through the night. It seemed rough at first, but after about three days, they slept through the night. Of course, it might have made them drink more during the day — I'm not sure. I'm all for anything that allows people to breastfeed with sanity. For me it meant night weaning — for you it might mean supplementing with formula for one feeding.

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  5. I had a total milk supply crunch with both kids at 10 months - it's a classic issue at La Leche League meetings, too. My lowest adult weight has been when each kid was 10 months old! IIRC it only lasted 1-2 weeks - then either the kid turned to eating more solids, I started making more milk, or both.

    I introduced yogurt by 9 months with both kids (milk sensitivities not an issue in our family.) I'd try to hang on with the pumping as much as you can (make sure you are eating well enough and getting good rest!) and hope she starts eating more solids soon. I'd choose to supplement if you can't keep up and yogurt doesn't go well. Good luck.

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  6. I know I'm not one to talk because I'm too chicken to try night weaning yet with Annie, but @Emily has a good point... there's a fourth option, you could night wean now. Drop at least one of the night feedings.

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  7. On the weaning option: when I tried that, LL just upped his daytime milk needs, so I didn't gain anything. But I definitely agree that cheese and yogurt can be started at 9 months, which might help get in extra calories from somewhere other than you.

    As for adding one bottle of formula -- that was the option I went with, when dropping night feedings didn't help, and waking up in the middle of the night to pump didn't help, and I was completely out of other options. The first day or two (or three) I cried every time I mixed the formula, because I felt like such a failure. I have no objection to people choosing it as an option, but I hated feeling like I was forced into it. Rationally it was fine, but it broke my heart.

    But, after several days, when LL clearly hadn't noticed the difference and was still doing great, I got used to it. And realized that decreased pressure to produce more and more and more milk was making me a LOT calmer. It was a tough decision, but I was a much happier mama one week later.

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  8. I was going to suggest night-weaning too, but am wondering if she would be getting enough milk with only the day feeds. I have no idea how much an ounce is either. My kids were night-weaned pretty early (10 weeks- Noah self weaned early- and at 6 months for Zoe), but had their first nurse at 5.30. Then again I was a SAHM and they fed every hour while they were awake, which I know is not an option for you.

    I would definitely not give her the extra feed at night, seeing you will most probably be working towards some kind of weaning soon.

    As for cheese, here in Italy, cheese is 'the' first food, introduced at 6 months. They start with Parmigiano, which is made with skim milk, so light and digestable. Then they move onto fresh cheeses. My kids never seemed to have any problems with it and love it to this day, and there was the risk of allergy ( seeing I have lots of food allergies?, but my ped didn't even consider not introducing it so early.

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  9. mary d10:40 AM

    I'd do #1. Like you, I'm a girl that needs a LOT of sleep or all hell breaks loose.

    We ended up supplementing J with formula -- I couldn't keep up with him. I forget when that started, but he got 1 bottle of formula a day at daycare. My husband said I fought this but I don't remember that (sleep deprivation really did me in!!). Same issues as Nicky -- rationally I was ok with it but not so much emotionally. That said, I have already decided that if this happens with #2 (currently 3 weeks old so we'll see what happens) that I will let go of the guilt and give him formula too if I can't keep up. It is not worth my sanity. And for you, that's going to be another 2 or 3 months? It won't end up being all that much formula in the end. I would NOT sacrifice the sleep -- she'll be fine. :)

    J also was sleeping through the night at 6 months which made a HUGE difference for me, sleep-wise. We woke him up to feed him at 10 pm or so, before we hit the sack. In the words of our ped: "He's going to need to eat in the night. Do you want HIM to pick, or do YOU want to pick what time?" So we picked the time. Is that something you could try? I do not know what kind of schedule you're on now.

    Let us know what you decide!

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  10. I was in a similar dilemna with #2 (and probably #1, but that was too far back to remember, heh). What I did was up the solids (cereals and purees) during the day, used up the freezer supply a little more each week, extended the length of time for my pumping sessions (although this didn't help much) and when we made it to 11.5 months, I started him on cow's milk.

    I don't know if any of that would work for you. My sister is just supplementing with formula to get through this period, and that's working fine for her and her babe.

    Good luck! And just remember, they are ALL good choices. Petunia will be fine.

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  11. Thanks for all the advice and ideas. I'll let you know what we end up doing.

    I should have said- we fully intend to nightwean soon. In fact, we have already successfully decreased our nightfeedings from 3 to 2. We haven't pushed further right now because we're still in the thick of the separation anxiety phase and I just don't think it would go well. We dropped Pumpkin from 3 nightfeedings down to 1 at the end of her 10th month, and I'm hoping to have similar (or even better!) success with Petunia at about the same age.

    Petunia helpfully caught yet another cold or something, so I was home with her today- which spared my frozen supplies a bit. When I am actually nursing her, I have no trouble keeping up with her needs. It is only when I'm trying to pump that I can't keep up.

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  12. I would go with option 3. I had the same problem with my twins, and was really freaking out over it. My ped said not to worry, just give them more solids during the day, and water to drink. They ate yogurt and lots of cheese at 10 months, but we did wait until 12 months to introduce milk. I would also sometimes sprinkle some formula into their cereal. I too had a somewhat irrational aversion to formula, probably for the same reason you have, but somehow it didn't bother me as much to just add it to solids as it would have to prepare a bottle for them to drink. I know this is silly.

    One more thought, could you squeeze in another nursing session in the morning before you go to work?

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  13. I would go with adding dairy to start off with. Your call that restricting certain foods is just a best guess is right! For a review (from an Australian perspective) see the "Infant feeding advice 2010" published by the Australian Society of Clinical Immunology and Allergy (ASCIA). I'm happy to follow their advice not to worry about delaying the introduction of potentially allergenic foods generally, but will probably give peanut products, tree nuts and sesame a miss.

    http://www.allergy.org.au/images/stories/aer/infobulletins/2010pdf/ascia_infant_feeding_advice_2010.pdf

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  14. Bother - looks like the link I pasted into the previous comment didn't work. I think if you google ASCIA the infant feeding advice link comes up under the main link.

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  15. I didn't want to jinx it so sorry for the late post. B is nightweened. It took four nights till she stopped waking up at one am in case I changed my mind but it's done. I don't knownif she's taking in more milk since she drinks right from the source, but she is eating more solids.

    So I vote for option #4. I don't think I could do #1 and I think you're batshit crazy for even considering #2 :).

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  16. I am having a similar issue. I've known since before I gave birth (end of April) that I would be gone for 7 days in mid-August. I've been trying my best to get a weeks worth of milk stored up, but I realized a few weeks ago that is just wasn't going to happen. Right now it seems like if she gets one feeding a day using formula, the breast milk should last the week. We've already tried feeding her formula to make sure that she will drink it and that it won't upset her digestive system. I was really hard on myself about this (which was just amplifying the problem), so it was kind of liberating to just make the decision to give her a little formula for this short time. It's also nice to know she can take formula without a problem in case there is ever a situation where that is the only option.

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  17. Cloud, I would do nos. 1 or 3. I had to supplement with formula at this age too as I had burned through my freezer stash and never could pump enough to fill his daycare bottles. My son was already used to bottles, so no big deal using a bit of formula. He could not have cared less. Of course I felt a bit bad about it, and we did have to pay for the formula, but it was also liberating not to have to do so much "milk math" as you say and/or worry about how much I was pumping.

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  18. I remember the same panic when my freezer supply dwindled to just a few bags. I kind of freaked because I think Pea was only 6 or 8 months old when it happened with her.

    Our sitters would add just a few spoons of fortified cereals to the kids' bottles during the day. That extended the milk supply. I also added the cereals to their pureed fruit and by 8 - 10 months I had them eating homemade pureed solids before bedtime.

    Breastfed just a bit at night -- more a comfort issue at 8+ months than starving for nutrition.

    I remember only being able to pump just enough for the next day's supply and never having extra for that last phase of real breastfeeding. It was scary, but I used to think that if they made it to this age then they are able to survive with things other than breastmilk.

    I think I stopped pumping at 12 months and kept breastfeeding both until 3.5 yo.

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